产OXA-23和OXA-51型碳青霉烯酶的鲍曼不动杆菌在某州立医院暴发

Tülin G. Gökmen, Beril Akçimen, B. Kayar, Mahdi Marzi, F. Köksal
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引用次数: 11

摘要

鲍曼不动杆菌是一种非发酵的革兰氏阴性杆菌,是重症监护病房中引起感染和流行病的重要病原体。碳青霉烯耐药通常由oxa型碳青霉烯酶组成。在这项研究中,我们旨在通过表型和基因型方法确定10床重症监护病房患者和环境样本中分离的鲍曼不动杆菌对碳青霉烯类的耐药性和克隆关系。采用多重pcr法检测OXA型β -内酰胺酶(blaOXA)基因,并采用脉冲场凝胶电泳(PFGE)法研究菌株间克隆关系。所有分离株均对碳青霉烯类耐药,并具有blaoxa -51和blaoxa -23样基因。此外,所有分离株经PFGE方法均100%相关。结果发现,呼吸机相关性肺炎患者分离株和重症监护病房呼吸机存活的分离株与PFGE 100%克隆相关,并且亚胺培南和美罗培南的MIC值相同。所有分离株均检测到blaOXA-23和blaOXA-51基因。这是一次短期的小爆发,是可以接受的。
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The outbreak of Acinetobacter baumannii producing OXA-23 and OXA-51 type carbapenemases in a state hospital
Acinetobacter baumannii is non-fermentative gram-negative bacilli which plays an important pathogen especially in intensive care units causing infections and epidemics. Carbapenem resistance often is consisted of OXA-type carbapenemase. In this study, we aimed to determine carbapenem resistance and clonal relationships of A. baumannii isolated from patient and enviromental samples by phenotypic and genotypic methods in 10-bed intensive care unit. Multiplex-PCR method was used to determine the genes of OXA type beta-lactamases (blaOXA) and clonal relations between strains were investigated by pulsed-field gel electrophoresis (PFGE) method. All of the isolates were found to be carbapenem resistant and had the blaOXA-51-like and blaOXA-23-like gene. Also, all of isolates were seen to be 100 % related by PFGE method. As a result, isolates of patients with ventilator-associated pneumonia and isolates survived on ventilator of Intensive Care Unit were found to be 100% clonal associated with PFGE and had same MIC values for imipenem and meropenem. blaOXA-23 and blaOXA-51 genes has been determined all of the isolates. It can be accepted a short-term and small outbreak.
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